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. 2012 Jan;35(1):99-104.
doi: 10.2337/dc11-1346. Epub 2011 Oct 25.

Serum uric acid levels and incident chronic kidney disease in patients with type 2 diabetes and preserved kidney function

Giacomo Zoppini  1 , Giovanni Targher, Michel Chonchol, Vittorio Ortalda, Cataldo Abaterusso, Isabella Pichiri, Carlo Negri, Enzo Bonora
Affiliations

Serum uric acid levels and incident chronic kidney disease in patients with type 2 diabetes and preserved kidney function

Giacomo Zoppini et al. Diabetes Care. 2012 Jan.

Abstract

Objective: Recent studies have suggested an association between hyperuricemia and adverse renal outcomes in nondiabetic populations. Data on the relationship between hyperuricemia and the risk of incident chronic kidney disease (CKD) in type 2 diabetic patients with normal or near-normal kidney function are lacking. We determined whether baseline serum uric acid levels predict the subsequent development of CKD in patients with type 2 diabetes.

Research design and methods: We followed 1,449 type 2 diabetic patients with normal kidney function and without overt proteinuria for 5 years for the occurrence of incident CKD (defined as overt proteinuria or estimated glomerular filtration rate [eGFR] <60 mL/min/1.73 m(2)).

Results: During a 5-year follow-up period, 194 (13.4%) patients developed incident CKD. The cumulative incidence of CKD was significantly greater in patients with hyperuricemia than in those without hyperuricemia (29.5 vs. 11.4%, P < 0.001). In univariate logistic regression analysis, the presence of hyperuricemia roughly doubled the risk of developing CKD (odds ratio [OR] 2.55 [95% CI 1.71-3.85], P < 0.001). After adjusting for age, sex, BMI, smoking status, diabetes duration, systolic blood pressure, antihypertensive treatment, insulin therapy, HbA(1c), eGFR, and albuminuria, hyperuricemia was associated with an increased risk of incident CKD (adjusted OR 2.10 [1.16-3.76], P < 0.01). In continuous analyses, a 1-SD increment in the serum uric acid level was significantly associated with a 21% increased risk of CKD.

Conclusions: In type 2 diabetic individuals with preserved kidney function, hyperuricemia seems to be an independent risk factor for the development of incident CKD.

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Figures

Figure 1
Figure 1
Association of sex-specific hyperuricemia with the development of incident CKD within subgroups. Data are expressed as ORs and 95% CIs.
See this image and copyright information in PMC

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